<?php
Template::AddCss("datePicker");
Template::AddJs("date");
Template::AddJs("jquery.datePicker");
?>
<script type="text/javascript">
$(function()
{
  Date.firstDayOfWeek = 0;
  Date.format = 'yyyy-mm-dd';
  $('.date-pick').datePicker();
});
</script>
<h3>Create a Reminder</h3>
<div class="error"><?php echo $error; ?></div>
<form method="post" action="">
<input type="hidden" name="index" value="<?php echo $index; ?>" />
<table>
  <tr>
    <td>Student's First Name:</td>
    <td><input type="text" name="first" value="<?php echo $reminder->first; ?>" /></td>
  </tr>
  <tr>
    <td>Student's Last Name:</td>
    <td><input type="text" name="last" value="<?php echo $reminder->last; ?>" /></td>
  </tr>
  <tr>
    <td>ID Number:</td>
    <td><input type="text" name="id" value="<?php echo $reminder->id; ?>" /></td>
  </tr>
  <tr>
    <td>Class:</td>
    <td><input type="text" name="class" value="<?php echo $reminder->class; ?>" /></td>
  </tr>
  <tr>
    <td>College:</td>
    <td><input type="text" name="college" value="<?php echo $reminder->college; ?>" /></td>
  </tr>
  <tr>
    <td>Email:</td>
    <td><input type="text" name="email" value="<?php echo $reminder->email; ?>" /></td>
  </tr>
  <tr>
    <td>Withdrawal Code:</td>
    <td><input type="text" name="withd" value="<?php echo $reminder->withd; ?>" /></td>
  </tr>
  <tr>
    <td>Withdrawal Date:</td>
    <td><input type="text" name="withdate" value="<?php echo $reminder->withdate; ?>" /></td>
  </tr>
  <tr>
    <td>Planned Return Time:</td>
    <td><input type="text" name="plnret" value="<?php echo $reminder->plnret; ?>" /></td>
  </tr>
  <tr>
    <td>Enrolled Status:</td>
    <td><input type="text" name="enrstat" value="<?php echo $reminder->enrstat; ?>" /></td>
  </tr>
  <tr>
    <td>Special Program:</td>
    <td><input type="text" name="specpgm" value="<?php echo $reminder->specpgm; ?>" /></td>
  </tr>
  <tr>
    <td>Academic Action:</td>
    <td><input type="text" name="acadact" value="<?php echo $reminder->acadact; ?>" /></td>
  </tr>
  <tr>
    <td>Note:</td>
    <td><textarea name="note"><?php echo nl2br($reminder->note); ?></textarea></td>
  </tr>
  <tr>
    <td>Reminder Date:</td>
    <td>
      <input class="date-pick dp-applied" type="text" name="reminder_date" value="<?php echo $reminder->reminder_date; ?>" />
      <a href="javascript: void(0);" class="dp-choose-date" title="Choose date"></a>
    </td>
  </tr>
  <tr>
    <td colspan="2"><input type="submit" value="Submit" /></td>
  </tr>
  <tr>
    <td colspan="2"><a href = "?q=reminders">Return to My Reminders</a></td>
  </tr>
</table>
</form>